A 27 year-old male was involved in head on collision at high speed. He was GCS 8 at the scene.
A CT Head was performed:
Questions
Q1. List 5 abnormalities on the CT brain.
1. depressed, comminuted fracture of the left temporal bone
2. fracture involving the left orbit
3. scalp haematoma overlying the fractured temporal bone (and you can even see a big laceration)
4. pneumocephalus
5. a small left sided acute subdural haemorrhage
6. a small left frontal intraparenchymal haemorrhage
Anything else?
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'In the Fast Lane': more Trauma Tribulations – #002 http://su.pr/2yF4jT and #003 http://su.pr/1AmIjA
That left sided bleed looks like an extradural; it is lenticular, at a classical site, and in a young brain.
probably le fort III fracture, subcut emphysema right orbit, some subarachnoid blood, cerebral oedema, mild midline shift
1. acute subdural (NOT extradural despite the site)
2. pneumocranium
3. depressed fracture temporal and would have to look up other – 4. sphenoid?
tight base and I think maybe some 5. uncal herniation?
no midline shift
not much room in those ventricles but hard to say if effaced on limited slices